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Abstract A shortage of physicians in local public hospitals is often a heated political issue. When local politicians have the authority to intervene in the management of a public hospital, they may increase the employment of physicians during election years in order to alleviate the shortage. We test this hypothesis empirically using a census of city hospitals in Japan from 2002 to 2011 (N = 4583). Our results support the hypothesis that the number of physicians increases in election years. This effect is stronger in cities with a greater population of elderly residents. We also find that physicians tend to come from university hospitals in the same region. Overall, this paper provides direct evidence of political intervention on physician employment. Highlights • A shortage of hospital physicians was a heated political issue in Japan. • We examine how the timing of mayoral elections affected local public hospitals in Japan. • The number of physicians increased in election years. • The effect was stronger in cities with a greater population of elderly residents. • We find that physicians came from university hospitals in the same region. [ABSTRACT FROM AUTHOR]

Although pre-electoral political manipulation of the budget — the political budget cycle (PBC) — has been long investigated by scholars, empirical findings are mixed at best. This is partly because of the non-random nature of election timing. There also exist ongoing debates over how the budget is manipulated for electoral purposes. We address these issues by exploiting a natural experiment in Japan, where the timing of both executive and legislative elections in municipalities is fixed, staggered, and as good as random, and by using the detailed items of the municipal budget. We find that total and capital expenditures follow the PBC, but tax revenue does not. We also find that executive elections are associated with the PBC, but legislative elections are not. Against the conventional wisdom that democratic or developed countries are free from the PBC, our case of Japan offers an intriguing exception. • We exploit a natural experiment in Japan to study political budget cycle (PBC). • The timing of elections in Japanese municipalities is staggered and as-if random. • Total and capital expenditures follow the PBC, but tax revenue does not. • Executive elections are associated with the PBC, but legislative elections are not. • While many democratic countries are free from the PBC, Japan is an exception. [ABSTRACT FROM AUTHOR]